Health Innovation East is hosting the East of England Stroke Forum until July 2025 to help connect healthcare professionals from across our region.

The first annual East of England Stroke Conference, held on 19 September 2023, was joined by over 200 attendees, with more than 25 speakers with vast experience within stroke care.

To open the day, we were fortunate to have Deb Lowe, Rebecca Fisher, and a virtual David Hargroves to cover the National Stroke Programme with Juliet Bouviere closing out the day with a presentation on the Patient-Reported Experience Measures. Other topics from the day included, improving stroke therapy SSNAP scores, screening for atrial fibrillation and developing a secondary prevention protocol for our patients. A full programme from the day can be found here.

Recordings of each presentation and entries from the poster competition can be found below. These resources are designed for health care professionals.

Our sponsors 2023

The East of England Stroke Forum Conference 2023 was sponsored by Daiichi-Sankyo* and Irwin Mitchell.

* The meeting was organised by Health Innovation East and sponsored through funding by Daiichi Sankyo. Daiichi-Sankyo has had no involvement in the organisation of the meeting.

East of England Stroke Forum Conference 2023

Presentation recordings:

Plenary and patient story

Speakers:

Sara Betsworth

Co-chair, East of England Stroke Forum Steering Group

Service delivery lead, Stroke Association

Sandra Ross

Suffered a stroke in September 2017, employed by the charity Different Strokes

View the slides here

National Stroke Programme

Speakers:

Dr David Hargroves

Consultant physician, East Kent Hospitals University Trust

National specialist adviser, NHS

GIRFT national clinical lead for stroke

Dr Deb Lowe

Consultant stroke physician and geriatrician, Wirral University Teaching Hospital NHS Foundation Trust

NHS national clinical director for stroke

Dr Rebecca Fisher

Principal research fellow, University of Nottingham

View Deb Lowe and Rebecca Fisher’s slides here

View David Hargroves’ slides here

Improving stroke therapy SSNAP scores: moving on up

Speaker:

Julia Sartorius

Lead Physiotherapist for Stroke, Lister Hospital.

Session synopsis:

We will outline the challenges that our busy, acute service has faced over the last few years – namely the pandemic, staffing shortages and recruitment problems.

This has inevitably impacted our SSNAP scores and explains the context behind our project.

Our quality improvement project is focused on our occupational therapy and physiotherapy services, with a goal to improve therapy SSNAP scores in domains 5,6 and 8. We will present our project and discuss early successes, but also highlight the barriers we have faced and our learning in relation to
this. We will finish by sharing our future ambitions and consider our progress in the context of the new stroke guidelines.

Learning outcomes:

Share our 7-step model for quality improvement and the benefits we have experienced from working closely with our QI team (SSEF E20)
Share our methods for improving intensity and responsiveness of occupational therapy and physiotherapy on ASU and HASU (SSEF E10)
Highlight the impact that ‘on the ground’ clinicians can make in implementing change under challenging circumstances and the importance of maintaining hope and resilience (SSEF E18)

View the slides here

Our experience of using Pharyngeal Electrical Stimulation
(PES) to help re-establish safe swallowing

Speaker:

Rebecca Oxtoby

Highly specialist SLT

UK therapy development manager, Phagenesis

Miriam Mitchell

Service lead-adult acute speech & language therapy, Mid and South Essex NHS Foundation Trust

Session synopsis:

An overview of our experience of using Pharynx – PES to help restore safe swallowing/improve secretion management in some patients post-stroke.

Learning outcomes:

To understand what is PES and what does it target
To identify suitable patients
To discuss with group our experience of starting using this type of treatment, the drawbacks, and positives of our experience

View the slides here

Accuracy of stroke and TIA diagnosis by acute stroke nurses

Speaker:

Catherine Go

Acute Stroke Nurse Specialist, Colchester Hospital

Rebecca Smith

Advanced stroke nurse practitioner

Session synopsis:

Accurate evaluation of patients presenting with acute stroke syndromes can be challenging in a sea of stoke mimics.

Acute stroke nurses play a vital role in early identification of stroke and TIA in the frontline, however literature on their diagnostic accuracy is scarce. ASNs’ diagnostic accuracy of stroke and TIA in this audit was acceptable with room for improvement.

Majority of missed strokes were found to be posterior strokes. Improvement plan includes ongoing breach reviews and feedback for reflective learning, as well as additional teaching sessions.

Learning outcomes:

Gain awareness on the role and accuracy of ASNs in the diagnosis of Stroke and TIA
Gain insight into reasons for misdiagnosis and common pitfall
Gain insight into the quality improvement plan implemented to improve assessment skills
and clinical judgment of ASNs’

View the slides here

Quality improvement initiative: early mobilisation post stroke

Speaker:

Lisa Marshall

Specialist physiotherapist, stroke unit, Colchester Hospital

Session synopsis:

To review early mobilisation post stroke with reference to the evidence base, our quality improvement project and current research.

Learning outcomes:

To have an understanding of the need for early mobilisation post stroke (SSEF E9 E10)
To have knowledge of the theory and evidence base of early mobilisation and how research outcomes change practice (SSEF E20)
To have an awareness of current therapy led research activity – AVERT dose (SSEF E20)

View the slides here

Multidisciplinary mortality review

Screening for atrial fibrillation: the SAFER trial

Speaker:

Dr Ramachandran Sivakumar

Consultant stroke physician and lead, Colchester General Hospital

Session synopsis:

This session will highlight the themes around stroke mortality and areas to focus to reduce mortality. The presenter will also share their experience of implementing multidisciplinary stroke specific mortality review.

Learning outcomes:

Structured stroke specific mortality review improves process and staff knowledge (E9, 11, 18, 19)
Focus on preventing deterioration is more useful
Empowerment of MDT staff is essential and effective
It is vital that staff are educated about decision-making process regarding palliative care decisions

Speaker:

Dr Rakesh Modi

Academic GP partner

Senior clinical research associate, Primary Care Unit, University of Cambridge

Clinical lead for research, Cambridgeshire and Peterborough ICB (South)

Chair, Inequalities Research Network

Session synopsis:

Dr Modi will discuss AF, screening and the SAFER trial, the delivery of screening programmes, and what this means for other screening programmes.

Learning outcomes:

The significance of atrial fibrillation with regards to stroke
The debate about screening for AF and screening in general
The importance of using evidence to deliver and implement programmes
The shortfalls in current AF care and how we can improve this for better stroke reduction

View the ‘multidisciplinary mortality review’ slides here

View the ‘screening for atrial fibrillation: the SAFER trial’ slides here

Improve the early identification and referral to specialist services of problematic tone and spasticity for patients following acute stroke

Developing a secondary prevention protocol for our patients

Speaker:

Samuel Hodgson

Clinical lead physiotherapist, Neurosciences service, Norfolk and Norwich University Hospital

Session synopsis:

This presentation will aim to evaluate the strategies used to implement a process for early identification of problematic tone and spasticity within an acute stroke service. The outcomes of the improvement project will be summarised as well as some of the barriers and suggestions for adaption and long-term implementation.

Learning outcomes:

To review the evidence base and importance of early assessment and identification of tone and spasticity.
To analyse a framework for early identification of tone and spasticity that could be adapted and transferred to individual services.
Gain a greater understanding into the faciliatory leadership skills needed as part of quality improvement methodology.

Speaker:

Alison Whear

Advanced clinical practitioner, Hertfordshire Community NHS Trust

Session synopsis:

I completed a Quality Improvement Project for my final year MSc Advanced Clinical Practice. This QI project developed a time efficient way to build in more secondary stroke education to patients during their rehabilitation stay. It was found many patients arrived at the unit with no knowledge of what may
have caused their stroke, why they were taking new medication and lifestyle risk factors of a secondary stroke and steps to improve these.

Through using the PDSA cycle method of quality improvement I was able to establish versatile methods for the unit to ensure all staff were involved in improving a patients stroke knowledge.

This has resulted in our patients and their carers/families being discharged back to the community with a clear understanding of the causes of their stroke and preventative measures to take to reduce their risk of a secondary stroke. They have an awareness of the six-month review process so they can begin to prepare for identifying their unmet needs and ensure they use the six-month review process to the maximum.

Learning objectives:

To ensure secondary stroke prevention and health education is a vital part of rehabilitation pathway for patients. To ensure patients have the answers to the questions about their stroke and individual risk factors.
To share the principles of quality improvement to ensure this is a regular part of practice for all professionals. To encourage education pathways to be developed so all staff, patients and carers become stroke champions.
To link with community pathways and service providers to enable the six-month review process to have a greater impact by starting the assessment with patients throughout their post-stroke journey. This should patients and their carers to become knowledgeable and informed of their unmet needs and the six-month review process to build on resolving these unmet needs rather than purely identifying.

View the ‘service improvement project’ slides here

View the ‘developing a secondary prevention protocol for our patients’ slides here

A service evaluation to support implementation of the Integrated Community Stroke Service using telerehabiliation in community stroke rehabilitation: a progress report

Speaker:

Dr Nicola Hancock

Associate pro-vice-chancellor for innovation, University of East Anglia

Session Synopsis:

This session will provide a rationale for exploring telerehabiliation as a service delivery model with the ICSS, and the service evaluation tools used to ensure breadth and depth of information is gained to underpin further decisions. It will then provide a progress report on a funded service evaluation in East of England community stroke services.

Learning outcomes:

To understand the evolution of remote working in community stroke services via the existing evidence base
To understand a mixed- methods service evaluation model in community stroke practice
To gain insight into current use of telerehabiliation/remote working in East of England community stroke services.

View the slides here

The power of connectivity

Speakers:

Louise Hornagold

Engagement lead, Stroke Association

Sara Betsworth

Co-chair, East of England Stroke Forum Steering Group

Service delivery lead, Stroke Association

Session synopsis:

Why connectivity is important (to information, expertise, and peers with experience)
Examples of connectivity through patient stories – Stroke Recovery Service and Stroke Association Connect
Reflecting on our individual agency in connecting

Learning outcomes:

An opportunity to reflect on why connectivity is critical and the role we all have to play
Understand more about the patient centred approach to Life After Stroke Services and remote support options
Identify a follow action to increase your connectivity

View the slides here

Patient story and closing comments

Speaker:

Julie Lesslie

Stroke survivor

Session synopsis:

A brief story of my stroke, how I was treated and my recovery up to the present day.

Poster competition entries:

Winning entry: “Driving After Stroke – A service evaluation to inform a new pathway”. The winning entry shares their work with driving assessment centres to provide ‘fitness to drive’ assessments for stroke survivors.

Driving after stroke – a service evaluation to inform a new pathway

Driving after stroke care poster